LAB VALUES - LONG Flashcards
The blood has 3 major types of cells
Erythrocytes
Leukocytes
Thrombocytes
Erythrocytes
Red Blood Cells
Erythrocytes Live
120 days
Erythrocytes Male – ERR
4.6-5.9 mill/m3
Erythrocytes Female –ERR
4.2-5.4 mill/m3
Red cells needed for tissue
oxygenation
Erythrocytes Elevated in ___ _____ or after ______ (due to need of O2)
high altitudes
activity
Need to make happy healthy RBCs
Good Genes
Can inherit genes like sickle cell
Healthy Kidneys
Erythropoietin
Healthy Thyroid
Hypothyroidism – decreases production of red cells
Erythropoietin
?
Hypothyroidism – decreases production of
red cells
Building blocks RBC’S
Vitamin B12
Iron
Folic Acid
Hemoglobin Male - ERR
13.0-18.0 g/dl
Hemoglobin Female ERR
12.0-16.0 g/dl
Hemoglobin Elevated in
pregnancy
Hemoglobin Decreased in hemorrhage, destruction of Hgb, lack of items to form Hgb, hemolytic anemia, renal disease, SLE, bone marrow suppression, etc.
hemorrhage,
destruction of Hgb,
lack of items to form Hgb,
hemolytic anemia,
renal disease,
SLE,
bone marrow suppression, etc.
Hemoglobin Decreased Potential for infection is
increased
Hemoglobin Decreased Potential for infection is Increased ex’s
Polycythemia Vera, Congestive Heart Failure, COPD
Polycythemia –
abnormal increase in the number of RBCs ??
Note that excessive intake can cause a
decrease in Hgb. ??
Hematocrit Determines the percentage of
RBCs in the plasma (roughly 3 times the Hgb)
Hematocrit Male ERR
45-52%
Hematocrit Female ERR
37-48%
HematocritDecreases in
pregnancy especially last trimester due to increase of serum volume
Hematocrit Also decreased in
anemias,
adrenal insufficiency,
leukemias,
Hodgkin’s Disease,
chronic illness,
acute and chronic blood loss,
hemolytic reaction
when hemoconcentration rises considerably
Increased in erythrocytosis, Polycythemia Vera, and shock
(MCV)
Mean Corpuscular Volume
Mean Corpuscular Volume
Describes the average size of RBC
MCV Formula
MCV = Hct ÷ RBC
(MCV) ERR
80-100 µm3
microcytic
<80 – (RBC too small) CONFIRM IS THIS A TYPE OF ANEMIA
9/10 iron deficiency anemia ??
Most iron deficiency anemias are child related
Iron is essential for vertical growth in kids
Iron deficiencies in adults are usually not diet related.
microcytic causes
Lead poisoning
Thalassemia (Cooley’s anemia)
GI Bleeds (adults
Growing kids – too much milk (no more than 16 oz/day, interferes with iron absorption)
Too much tea (tannins interfere with iron absorption)
Celiac disease (interferes with iron absorption)
Long term PPIs
macrocytic
>100 – (RBC too large)
Think booze (liver disease)
CONFIRM IS THIS A TYPE OF ANEMIA
macrocytic causes
Think booze (liver disease)
Hemolysis
Certain drugs
megaloblastic
>120 – anemia
megaloblastic causes
B12 or folic acid deficiency
Vegans
PPI long term use
MCH (what does mch mean?)
Mean Corpuscular Hemaglobin
Amount of Hgb in a single cell
MCH ERR
27-32 pg
(MCHC)
Mean Corpuscular Hemaglobin Concentration
Portion of each cell occupied by Hgb
Seen in iron deficiency anemia
Reticulocytes
Immature RBC, elevated with hemorrhage (takes 1-4 days to mature)
Immature RBC, elevated with hemorrhage (takes 1-4 days to mature)
?
Reticulocytes ___ - ____% of total RBC
0.5-2.5
Reticulocytes Slightly increased in
pregnancy
Reticulocytes Increase – after acute
blood loss. Iron deficiency anemia, sickle cell disease due to the destruction of the RBC
Reticulocytes Decrease – w/
Reticulocytes
Leukocytes
White Blood Cells
Granulocytes
Blood consists of two types of white blood cells (WBC), viz,granulocytes and agranulocytes.
Granulocytes
Basophils, neutrophils, and eosinophils
Agranulocytes
Lymphocytes and Monocytes
Neutrophils __-__% of WBC
40-80 % ( GRANULOCTYES
Neutrophils Bands are immature
neutrophils
Neutrophils Segs are
mature
Neutrophils Life span
a couple of hours
Neutrophils Left shift –
Bands greater than segs (infection)
Neutrophils Right shift –
Segs greater than bands (liver disease, pernicious anemia)
Neutrophils Phagocytic –
job is to eat virulent bacteria!
Eosinophils 0-5%
Granulocytes, cont
Respond to foreign protein (allergic response)
Responds to parasites
Does not respond to virus or bacteria
Eosinophils 0-5% Respond to foreign protein (allergic response) EX
Ragweed, pollen, dust, peanuts, some drugs to name a few.
Eosinophils Responds to
parasites
Eosinophils Does not respond to
virus or bacteria
Basophils 0-2%
Granulocytes,
Look at an attack on the body, releases heparin to prevent clotting and sends WBC to site of attack
Elevated in graft rejections
Decreased in hypothyroidism
Elevated in graft rejections
?
Decreased in hypothyroidism
?
Lymphocytes __-_____% OR wbc
10-40% of WBC
T Cells (CD3+) – 70-80% ARE
(Killer cells)
T Cells Stimulate release of
B cells
B cellsResponsible for
cellular immunity
B Cells
(CD19+) – 10-20% (produce antibodies)
NK Cells
(CD16+) Natural Killer Cells – 10%
Lymphocytes Decreased in immunodeficiency disorders, lupus, antineoplastic drug therapy, sepsis, ischemia
lupus,
antineoplastic drug therapy,
sepsis,
ischemia
Thrombocytes
Platelets
Platelets Cause
homeostasis
ERR Platelets Range
150,000 - 450,000
Platelets Life span
5-10 days
PlateletsDie in the
spleen
Decrease platelets and increase WBCs is a sign of
sepsis
Platelets are decreased:
CHF
Viral or bacterial infections
HIV
Alcohol toxicity
Renal disease
After massive blood transfusion (dilution effect)
Platelets are increased:
Iron deficiency anemia
Essential thrombocytopenia
Asphyxiation
Rheumatoid Arthritis, SLE, other collagen diseases
Chronic pancreatitis, TB, inflammatory bowel diseases
Erythrocyte Sedimentation Rate
Measures the speed in which RBC settle in a tube of anticoagulated blood
Measures the speed in which RBC settle in a tube of anticoagulated blood
?
Erythrocyte Sedimentation Rate ERR Male:
0-15 mm/hr
Erythrocyte Sedimentation Rate ERR Female:
0-20 mm/hr
Erythrocyte Sedimentation Rate ERR Pregnancy ERR
0-15 mm/hr
Erythrocyte Sedimentation Rate Increased in
pregnancy, inflammation, tissue injury, rheumatoid arthritis, PID, AIDS
Plasma
55% of blood volume
Straw colored
Contains proteins, lipids, carbohydrates, glucose, electrolytes, vitamins, hormones
Serum
Plasma minus the clotting protein fibrinogen
Used for certain chemistry tests and routine blood bank tests
Clotting Studies
Prothrombin time (PT)
INR
Activated partial Prothrombin time (PTT)
D-Dimer
Prothrombin time (PT)
~15 seconds
INR
<2
Activated partial Prothrombin time (PTT)
~30 seconds
D-Dimer Increased with:
DIC,
arterial and venous thrombosis,
renal or liver failure,
pulmonary embolism,
MI,
malignancy,
inflammation,
severe infection,
COVID-19 (diffuse clotting)
D-Dimer Normal Values
<250µg/L or <1.37 nmol/L
Can do on spinal fluid to rule out
subarachnoid hemorrhage (SAH). Positive in SAH. ??
Hematologic Tests You are looking at:
Oxygenation
Infectious processes
Bleeding
When to call the physician
Look at trends. Is it sudden or slow changes?
Look at mental status- irritability, restlessness
Look at activity or at rest – Increased respirations, increased SOB
Look at HR increase >20 B/Min or greater than 120
Look at skin – petechiae (sudden – decreased platelets)
When to call the physician Look at trends. Is it sudden or slow changes?
IN A SUDDEN CHANGE YOU CALL DOC
Look at mental status- irritability, restlessness
??
Look at activity or at rest – Increased respirations, increased SOB
CALL THE DOC:?
Look at HR increase >20 B/Min or greater than 120
CALL THE DOC:?
Look at skin – petechiae (sudden – decreased platelets)
CALL THE DOC:?
Herbal effects
Garlic – risk of increased bleeding
Ginkgo – risk of increased bleeding
Echinacea – impairs wound healing and can effect immunosuppressive drugs
Glucose
Fasting
Random
2 hour post prandiial
Glucose tolerance test
Hemaglobin A1C or Glycohemoglobin
Glucose Fasting ERR child and ERR adult
60 – 100 mg/dl (Child)
.70-100 mg/dL (Adult)